The URL can be used to link to this page

Home My WebLink AboutWhaler, Michelle 87383Co�° °"'❑CAMA ❑DREDGE & FILL N9 87383 A B C D Previous permit 's GENERAL PERMIT Date previous permit issued ❑Modification ❑ Complete Reissue ❑ Partial Reissue As authorized by the State of North Carolina, Department of Environmental Quality and the �-Coastal Resources Commission in an area of environmental concern pursuant to: 15A NCAC ❑ yl Rules attached. General Permit Rules available at the following link: wwwdgg.nc.gov/CAMArules Applicant Name �'� fill jt t.1 Address /' �� City ��1 i( State ZIP Phone#('.h!.')! Authorized Agent � r Project Location (County): Street Address/State Road/Lot #(s) Subdivision City Affected ❑CW ❑EW ❑PTA I .ES ❑PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW YYYYYY---❑------'''"' SPIMA ❑ PWS Closest Mal. Wtr. Body ORW: yes/no PNA: yes/a�) Type of Project/ Activity (Scale: Shoreline Length %r7,() - I i Access Length w I Pier(dockllength. Fixed Platform(s) {' i j I Floating Platform(s) _ Finger piers)-""`v- Total Platform area �_. .�tt} - _I / — Groin length/Jf „'"-'_•"_'._.. Bulkhead/ Riprap length Avg distance offshore C`J — Breakwater/Sill I Max distance/length Basin, channel Cubic yards Boat ram � —_ a, I ' I ! I Boathouse/Boatlift ! I - ' 'A Beach Bulldozing Other _ _ __'. _ T j _— SAV observed: yes no Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Attached: yes no - .._ _... A building permit/zoning Permit may be required by Permit u iANrHrurv[wpovrrcntaraeone/ See note on back regarding River Basin rules See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature **Please read compliance statement on Application Feels) tit** Signature _ Check p/Money Order Issuing Date Expiration Date J ❑CAMA ❑ DREDGE & FILL N9 87383 A B C D Previa GENERAL PERMIT Date r permit � Date previous permit issued F�JNevv ❑ Modification [:]Complete Reissue ❑ Partial Reissue As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to: I SA NCAC ❑ Rules attached. F1 General Permit Rules available at the following link: wwwdeo n<gov/CAMAmIes Applicant Name Address Y City State ZIP Phone # (_.) Email Affected ❑CW ❑EW AEC(s): ❑OEA ❑IHA Type of Project/ Activity ❑ PTA ES ❑ PTS ❑uW Y❑—'SPIMA ❑PWS PNA: yes/no Authorized Agent / Project Location (County): Street Address/State Road/Lot #(s) Subdivision City Adj. Wtr. Body Closest Mal. Wtr. Body (Scale: ) rM"CEMMEN C®C MEN CC �:E I ME�C■-- Avg distance offshore Breakwater/Sill Max distance/ length Boathouse/ Boatlift Beach Bulldozing Other NEWS Sol ME �:■.■■ ■■■■�■■�d■■iis�rilMEN ■�1 ■ ■■ ■ A building permit/zoning permit may be required by: J ❑TAR/PAM/NEUSE/BUFFER (circle one) Permit Conditions ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) ! Agent or Applicant PRINTED Name , Signature **Please read compliance statement on back of permit** Application Feels) Check N/Money Order Permit Officer's PRINTED Name Signature Issuing Date Expiration Date ( uVrN C 0 P `1 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: M j � e 1 i e ►v 1i Mailing Address: Phone Number: Email Address: I certify that I have authorized r Ay 1 Vpe K-:S. C/C141 Pe AgentI Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: o �• ju �olOt 0 1 i I;`H, —q6 11)Vx, ka(,V4er<i(7tN 1�,e'ttr Pho� at my property located at 4 ag Ce-C�.rS'o N rC in County. I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: Signature / Print or Type Name Title Date This certification is valid through I fie CU(k RECEIVED MAY 0 4 2022 DCM-MHD CITY I hereby certify that I own property adjaceht to property located at on a in and/or N.C. as shown below, the development proposed at the above The applicant has described to me, locati I have no objection to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) v SECTION . - t understand that a pier, dock, mooring pilings, breakwater, boathouse, lit, or groin must be set back a minimum distance of 15' from my area of riparian aaess unless waived by me. (If you wish to waive the setback, you must initial the appropriate blark below.) I do wish to waive the 15' setback requirement. I do not wish to waive the (Prelperty4owner Information) Signature V. h Mew (n0.(Zv, print or Type Nam :z L ,1y:nc( lsanz Mailing Addres City/statelzip --i S `l U--) Le In Telephone Number Date 15' setback requirement. (Adjacent Property Owner information) I Sign t) C AS Print or Toe Name 75l r All9.3 - 6-6 A a- t� (Re�isedfflg0 D MAY 0 4 207.2 DCM-MHD CITY Re i U rl() W'YN ADJACENT RIPARIAN PRC I hereby ,certify that I own property adjacent to located at on v h)d\ J in C; V I \ ( WW YI�_'s and/or N.C. . J I J (Waterbody) The applicant s described to me, as shown below, the development proposed at the above to ion. �Ih�-ave no objection to this proposal. � jsciion5lo this-prAp+�-----' _. DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill In description below or attach a site drawing) Je— V0VN� WIRSECTION unless waived by me (If you E-jcwater, boathouse, Aor groin must be set tha I understand t a pier, dock, mooring p 9 back a minimum distance of 15' from my area of riparian aaess wish to waive the setback, you must initial the appropriate W*belctw ) I do wis o waive the 15' setback requirement. do not wish to waive the 16 setback requirement. (Property ner Information (F)djacen L U-- Signature li 4� h.cl(P t'l1l�k({tom Pnnt orType NamA : t v� U4 �z r% G i-,t Y MailingAdd res nA IH�Ia� � City/state/Zip ^1I"^ $k{ Lc-1LD�' 62 Telephone Number Dote i V P ni ype Name 3p $_� 7 ingAddressl7z �S ea41 (Revised 6/l fl'Y012) RECEIVED MAY 0 4 2022 , 0CM-N,1HL) GffY